Buffalo, NY, 14211, USA
5 days ago
Billing Specialist
**FIND YOUR FUTURE** We're excited about the potential people bring to our organization. You can grow your career here while enjoying first-class perks, benefits and commitment to diversity and inclusion. **Overview** The Billing Specialist assists with the various activities of the pharmacy operations not requiring the professional judgment of the pharmacist. The Billing Specialist is primarily responsible for completing the billing of both pharmacy and medical claims and adjudicating rejections. **Qualifications** + High school diploma or GED required. National Pharmacy Technician Certification (CPhT) preferred. + One (1) year of experience working in a high-volume pharmacy, or equivalent setting, required, or six (6) months as a temporary associate in the Reliance Rx Operations & Compliance department. + Experience working with online claims processing system preferred. + Effective oral and written communication skills and an aptitude for working with other health care professionals. + Ability to lift a minimum of 5 lbs. + Proven examples of displaying the Reliance values: Collaborative, Accessible, Results-Oriented, Empowering, and Supportive. **Essential Accountabilities** + Responsible for billing all claims (pharmacy and medical) and managing rejections to ensure appropriate follow up and delivery promise times are met. + Act as a liaison between patients and insurance companies, and facilitate communication between patients and doctors, medical staff and administrative staff. + Work with payors to resolve any billing issues. + Ensure Reliance Rx is following CMS guidelines per Medicare and Medicaid guidance + Confirmation of billing accuracy and payor billing/shipping requirements. + Process and set up deliveries to medical offices. + Medical claims billing for both supplies and medications. + Confirm financial aspects of the claims prior to them leaving the facility. + Portal management including refill reminders, processing orders from the portal, and completing patient registrations. + Financial assistance coordination with patients for foundation care, copay assistance, or free medication programs where applicable. + Assist the Patient Care Specialists in workflow and with incoming and outgoing calls in accordance with business needs, to include but not limited to: + maintaining patient records; filing and documentation duties. + set up and data entry. + financial arrangements and collecting co-payments. + prior authorization assistance with offices. + coordination of benefits. + promote information sharing and continuous process improvement. + Function in strict accordance with standard, written procedures and guidelines with deviation approved by the supervising pharmacist. Immigration or work visa sponsorship will not be provided for this position Hiring Compensation Range: $20.50 - $21.50 hourly _Compensation may vary based on factors including but not limited to skills, education, location and experience._ In addition to base compensation, associates may be eligible for a scorecard incentive, full range of benefits and generous paid time off. The base salary range is subject to change and may be modified in the future. _As an Equal Opportunity / Affirmative Action Employer, Independent Health and its affiliates will not discriminate in its employment practices due to an applicant’s race, color, creed, religion, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender identity or expression, transgender status, age, national origin, marital status, citizenship and immigration status, physical and mental disability, criminal record, genetic information, predisposition or carrier status, status with respect to receiving public assistance, domestic violence victim status, a disabled, special, recently separated, active duty wartime, campaign badge, Armed Forces service medal veteran, or any other characteristics protected under applicable law._ _Click here (http://www.independenthealth.com/about/careers/additional-eeo-aap-information)_ _for additional EEO/AAP_ _or Reasonable Accommodation_ _information._ Current Associates must apply internally via the Job Hub app. The Independent Health Family of Companies, headquartered in Buffalo, NY, serves nearly 400,000 members and provides innovative health care products and benefits designed to engage consumers in their health and well-being. Established in 1980, our comprehensive portfolio includes Pharmacy Benefit Dimensions, Reliance Rx, Nova Healthcare Administrators, Care for You and the Independent Health Foundation. Our culture sets us apart. Our core values drive who we are and the work we do. As a member of our family, you’re part of something special, in your work and in the community. We understand and appreciate that everyone has unique experiences, perspectives and identities which is why we pledge to create a safe space where all people and ideas are welcomed. We are here to continue learning and to generate important dialog. We are committed to doing what matters most - reaching out, working together, and caring for our community. A healthy community benefits everyone who lives in it. You too can be part of making difference in the lives of others, together we achieve so much more. Please click here (http://www.independenthealth.com/about/community-report) to view our Community Reports. **Apply today and join us on the journey to a happier, healthier, and more inclusive community.** We are a drug-free workplace. We are committed to providing reasonable accommodations for qualified individuals with disabilities and disabled veterans. An applicant for employment in need of an accommodation to participate in the application and recruitment process should contact Human Resources at: accommodations@independenthealth.com or Human Resources, 511 Farber Lakes Drive, Williamsville, NY 14221. _Please note, we do not accept unsolicited resumes. We do not accept resumes from headhunters, placement agencies, or other suppliers that have not signed a formal agreement with us._
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